Individual provider Active NPI

Allison Gordon, MD

  • Dermatology Physician
  • New York, NY
National Provider Identifier
1134547805
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
292296 Issued in NY
Practice address
530 East 74TH Street
New York, NY 10021
Phone
(646) 608-2339
NPI assigned
Mar 31, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 292296 NY Primary

Addresses

Primary practice location

530 East 74TH Street
New York, NY 10021

Mailing address

530 E 74TH Street
9TH Floor
New York, NY 10021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181017003007 NY Practitioner - Dermatology 1557613692 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorial Dermatology GroupGroup PAC ID 1557250818, 19 clinicians

Practice addresses (Care Compare)

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.77 of 100Reported as group
Quality
84.67
Improvement activities
40
Cost
66.9

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions69
Removal or shaving of skin growth1-10
Skin biopsy98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
292296NYMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Dermatology Group Dermatology CurrentSince Jan 1, 2020 Accepting new patients
Montefiore Medical Center CurrentSince Sep 14, 2018 Accepting new patients
Montefiore Medical Center CurrentSince Sep 14, 2018 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

633 3rd Ave
Lbby 3
New York, NY 10017
Phone (848) 225-6000

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: akutner@montefioredirect.com
  • Direct secure messaging: agordon26040@mskcc.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1134547805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 E 74TH STREET",
            "address_2": "9TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 EAST 74TH STREET",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10021",
            "telephone_number": "646-608-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "ALLISON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2021-07-09",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "292296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.